<p>Please provide your credit card information.</p>

<form action="<?= $payment_method_obj->get_form_action($payment_method, $order) ?>" method="post">
	<?= flash_message() ?>
	<ul class="form">
		<li class="field text left">
			<label for="CNAME">Cardholder Name</label>
			<div><input autocomplete="off" name="transaction[credit_card][cardholder_name]" value="<?= $payment_method_obj->get_field_value('transaction[credit_card][cardholder_name]') ?>" id="CNAME" type="text" class="text"/></div>
		</li>		
		
		<li class="field text right">
			<label for="ACCT">Credit Card Number</label>
			<div><input autocomplete="off" name="transaction[credit_card][number]" value="<?= $payment_method_obj->get_field_value('transaction[credit_card][number]') ?>" id="ACCT" type="text" class="text"/></div>
		</li>

		<li class="field text left">
			<label for="EXPDATE">Expiration Date (MM/YY)</label>
			<div><input autocomplete="off" name="transaction[credit_card][expiration_date]" value="<?= $payment_method_obj->get_field_value('transaction[credit_card][expiration_date]') ?>" id="EXPDATE" type="text" class="text" maxchars=4/></div>
		</li>

		<li class="field text right">
			<label for="CVV">
				Card Verification Value (CVV)
			</label>
			
			<div><input autocomplete="off" name="transaction[credit_card][cvv]" value="<?= $payment_method_obj->get_field_value('transaction[credit_card][cvv]') ?>" id="CVV" type="text" class="text"/></div>
		</li>
		
		<!-- Uncomment this code if you want to support customer payment profiles
		<? if ($payment_method->supports_payment_profiles() && $this->customer): ?>
			<li class="field checkbox">
				<div><input type="checkbox" name="transaction[options][store_in_vault]" value="true" id="create_customer_profile" /></div>
				<label for="create_customer_profile">Save my credit card</label>
			</li>
		<? endif ?>
		-->
	</ul>
	<div class="clear"></div>
	
	<?
		$hidden_fields = $payment_method_obj->get_hidden_fields($payment_method, $order);
		foreach ($hidden_fields as $name=>$value):
	?>
		<input type="hidden" name="<?= $name ?>" value="<?= h($value) ?>"/>
	<? endforeach ?>

	<input type="submit" value="Submit"/>
</form>